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Chronic Diseases: Biopsychosocial Impact, Interventions and Preventive Measures

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 89288

Special Issue Editors


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Facultad de Fisioterapia y Enfermería y Fisioterapia de Toledo, Universidad de Castilla la Mancha, 45005 Toledo, Spain
Interests: preventive activities and public health; physical activity and health; nursing care; women and health; quality of life; sexuality; mood; chronic diseases
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Guest Editor
Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Universidad de Castilla la Mancha (UCLM), 45071 Toledo, Spain
Interests: ageing; older people; polypharmacy; preventive activities and public health; physical activity and health; nursing; violence; elder abuse
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Guest Editor
Social and Health Care Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
Interests: physical activity; body composition analysis; body composition; childhood obesity
Special Issues, Collections and Topics in MDPI journals

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Facultad de Fisioterapia y Enfermería, Grupo IMCU, Universidad de Castilla la Mancha (UCLM), 45071 Toledo, Spain
Interests: older people; nursing; physical activity; body composition; childhood obesity
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Didactics of Musical, Plastic and Body Expression, University of Jaen, 23071 Jaen, Spain
Interests: body bomposition; physical activity; exercise science; physical activity assessment; physical fitness
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In addition, due to the physical effect they produce, chronic diseases also have a strong psychosocial impact on both the sufferer and his or her family members. These diseases can affect mood, quality of life, sexuality, self-esteem, interpersonal relationships, etc. Thus, it is important to establish interventions both to prevent and diagnose these diseases early and to establish care that can improve the quality of life, sexuality, moods, etc. of the people who suffer from them.

This Special Issue, entitled “Chronic Diseases: Biopsychosocial Impact, Interventions and Preventive Measures” seeks papers on new research aimed at preventing chronic diseases and identifying problems related to them and interventions to improve the health status of people who suffer from them. We also welcome high-quality systematic reviews related to these issues.

Prof. Dr. Ana Isabel Cobo-Cuenca
Prof. Dr. Juan Manuel Carmona-Torres
Prof. Dr. Diana Patricia Pozuelo-Carrascosa
Dr. José Alberto Laredo-Aguilera
Prof. Dr. Pedro Ángel Latorre Román
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Anxiety
  • Cancer
  • Cardiovascular diseases
  • Chronic diseases
  • Quality of life
  • Mental health
  • Mood
  • Physical activity
  • Physical and mental health
  • Programming effects
  • Sexuality
  • Social support

Published Papers (18 papers)

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18 pages, 1296 KiB  
Article
A Concept Analysis of Illness Intrusiveness in Chronic Disease: Application of the Hybrid Model Method
by Youngjoo Do and Minjeong Seo
Int. J. Environ. Res. Public Health 2022, 19(10), 5900; https://doi.org/10.3390/ijerph19105900 - 12 May 2022
Cited by 3 | Viewed by 1721
Abstract
This study clarifies the concept of illness intrusiveness in patients with a chronic disease using the hybrid model method. To clarify the dimension, attributes, and definition of illness intrusiveness in chronic disease, three phases of analysis were conducted. In the theoretical phase, a [...] Read more.
This study clarifies the concept of illness intrusiveness in patients with a chronic disease using the hybrid model method. To clarify the dimension, attributes, and definition of illness intrusiveness in chronic disease, three phases of analysis were conducted. In the theoretical phase, a working definition was devised through a systematic review. In the fieldwork phase, individual in-depth interviews were conducted with nine participants with chronic diseases. In the final analytic phase, the results were integrated through comparison and review. There are four domains and eleven attributes of illness intrusiveness in chronic disease. The domains include physical, psychological, social/contextual, and spiritual. The physical domain consists of four attributes: pain, fatigue, physical malfunction, and change of body image. The psychological domain consists of three attributes: psychological weakness, uncertainty, and stigma. The social/contextual domain is made up of three attributes: withdrawal of role play, limit of daily life, and burden of changing health habits. Finally, the spiritual domain had one attribute: unstable spiritual state. Thus, based on the study findings, it is necessary to develop a suitable illness intrusiveness in chronic disease assessment scale to assess chronic disease patients. Full article
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14 pages, 632 KiB  
Article
Increased Patient Empowerment Is Associated with Improvement in Anxiety and Depression Symptoms in Type 2 Diabetes Mellitus: Findings from the INDICA Study
by Andrea Duarte-Díaz, Himar González-Pacheco, Amado Rivero-Santana, Yolanda Ramallo-Fariña, Lilisbeth Perestelo-Pérez, Yolanda Álvarez-Pérez, Wenceslao Peñate, Carme Carrion, Pedro Serrano-Aguilar and on behalf of the INDICA Team
Int. J. Environ. Res. Public Health 2022, 19(8), 4818; https://doi.org/10.3390/ijerph19084818 - 15 Apr 2022
Cited by 4 | Viewed by 2969
Abstract
Introduction. In cross-sectional analyses, higher levels of patient empowerment have been related to lower symptoms of anxiety and depression. The aims of this study are: (1) to assess if patient empowerment predicts anxiety and depression symptoms after 12 and 24 months among patients [...] Read more.
Introduction. In cross-sectional analyses, higher levels of patient empowerment have been related to lower symptoms of anxiety and depression. The aims of this study are: (1) to assess if patient empowerment predicts anxiety and depression symptoms after 12 and 24 months among patients with type 2 diabetes mellitus, and (2) to analyze whether a change in patient empowerment is associated with a change in anxiety and depression level. Methods. This is a secondary analysis of the INDICA study, a 24 month-long, multi-arm randomized controlled trial. Patient empowerment (DES-SF), depression (BDI-II), and state-anxiety (STAI-S) were assessed at the baseline (pre-intervention) and after 12 and 24 months. Multilevel mixed linear models with a random intercept were performed to correct for our clustered data. Results. The multilevel regression models showed that the baseline empowerment did not significantly predict anxiety and depression after 12 and 24 months. However, a higher increase in patient empowerment was significantly associated with reductions of anxiety (p < 0.001) and depression levels (p < 0.001). This association was not significantly different between the two follow-ups. Conclusion. This study contributes to the knowledge on how to reduce affective symptoms in patients with uncomplicated T2DM through comprehensive patient-centered interventions, and it highlights patient empowerment as a significant contributor. Full article
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13 pages, 1127 KiB  
Article
Let It Beat: How Lifestyle and Psychosocial Factors Affect the Risk of Sudden Cardiac Death—A 10-Year Follow-Up Study
by Jana Obrova, Eliska Sovova, Katerina Ivanova, Jana Furstova and Milos Taborsky
Int. J. Environ. Res. Public Health 2022, 19(5), 2627; https://doi.org/10.3390/ijerph19052627 - 24 Feb 2022
Cited by 3 | Viewed by 1770
Abstract
(1) Background: The aim of this study was to evaluate the lifestyle and occurrence of psychosocial factors in patients with a high risk of sudden cardiac death (SCD) and to explore their effect on the occurrence of the adequate therapy of an Implantable [...] Read more.
(1) Background: The aim of this study was to evaluate the lifestyle and occurrence of psychosocial factors in patients with a high risk of sudden cardiac death (SCD) and to explore their effect on the occurrence of the adequate therapy of an Implantable Cardioverter Defibrillator (ICD). (2) Methods: In this retro-prospective single-centre study, a group of patients aged 18–65 years old, who underwent the first ICD implantation for primary (PP) or secondary (SP) prevention between 2010–2014, was studied. The control group consisted of pair-matched (age ± 5 years, gender) respondents without a high risk of SCD. Information was obtained using a self-reported questionnaire and hospital electronic health records. The adequacy of ICD therapy was evaluated regularly until 31 January 2020. Multivariate logistic regression models were employed to assess the risk of SCD. (3) Results: A family history of SCD, coronary artery disease, diabetes mellitus and depression significantly aggravated the odds of being at a high risk of SCD. The occurrence of an appropriate ICD therapy was significantly associated with being in the SP group, BMI, education level and TV/PC screen time. (4) Conclusions: Lifestyle and psychosocial factors have been confirmed to affect the risk of SCD. Early identification and treatment of coronary artery disease and its risk factors remain the cornerstones of preventive effort. Further research is needed to evaluate the complex nature of psychosocial determinants of cardiac health. Full article
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12 pages, 351 KiB  
Article
The Dose–Response Relationships of Different Dimensions of Physical Activity with Daily Physical Function and Cognitive Function in Chinese Adults with Hypertension: A Cross-Sectional Study
by Meng Ding, Ningxin Jia, Yanan Zhou and Bin Li
Int. J. Environ. Res. Public Health 2021, 18(23), 12698; https://doi.org/10.3390/ijerph182312698 - 02 Dec 2021
Cited by 6 | Viewed by 2212
Abstract
Objective: The purpose of this study was to explore the dose–response relationships of different dimensions of physical activity (intensity, time, frequency, capacity, and metabolic equivalent) with daily physical function (DPF) and cognitive function (CF) in Chinese adults with hypertension. Methods: The 6216 hypertensive [...] Read more.
Objective: The purpose of this study was to explore the dose–response relationships of different dimensions of physical activity (intensity, time, frequency, capacity, and metabolic equivalent) with daily physical function (DPF) and cognitive function (CF) in Chinese adults with hypertension. Methods: The 6216 hypertensive patients included in this study were from the China Health and Retirement Longitudinal Study (CHARLS), which was conducted in 2015. Physical activity (PA) was divided into vigorous PA (VPA), moderate PA (MPA), and light PA (LPA). Linear regression models and binary logistic regression models were established to assess the associations with indicators. Results: Patients with VPA have a lower probability of impaired DPF; however, patients with VPA had lower CF scores. Patients with nearly all the aspects of MPA have lower rates of impaired DPF and higher CF scores (p < 0.05). Patients with LPA have a lower probability of impaired DPF and higher CF scores. In addition, patients with between 1800 and 2999 MET-minutes per week had the lowest rates of impaired DPF (OR = 0.10, 95% CI 0.02, 0.39) and the highest CF scores (β = 3.28, 95% CI 2.25, 4.31). Conclusions: This study found that patients with hypertension with moderate-intensity physical activity (nearly all aspects) and LPA had better DPF and CF. The best daily physical function and CF was with METs of 1800–2999 min per week. However, VPA should be recommended with caution in Chinese adults with hypertension. Full article
14 pages, 350 KiB  
Article
Associations between Socio-Demographic Factors and Hypertension Management during the COVID-19 Pandemic: Preliminary Findings from Malaysia
by Mohamed Hassan Elnaem, Nur Hasyimah Kamarudin, Nabeel Kashan Syed, Hasniza Zaman Huri, Inderpal Singh Dehele and Ejaz Cheema
Int. J. Environ. Res. Public Health 2021, 18(17), 9306; https://doi.org/10.3390/ijerph18179306 - 03 Sep 2021
Cited by 10 | Viewed by 3475
Abstract
The perspectives of hypertensive patients on the state of hypertension control during the ongoing pandemic restrictions have not been extensively studied in Malaysia. Therefore, this study aimed to assess the impact of socio-demographic factors, health literacy, and adherence on the overall hypertension management [...] Read more.
The perspectives of hypertensive patients on the state of hypertension control during the ongoing pandemic restrictions have not been extensively studied in Malaysia. Therefore, this study aimed to assess the impact of socio-demographic factors, health literacy, and adherence on the overall hypertension management in a group of Malaysian hypertensive patients during the COVID-19 pandemic. An anonymous, online cross-sectional study was conducted over three months that involved a group of Malaysian adults with hypertension. A validated, self-administered 30-item questionnaire was prepared in Malay and English languages on Google Forms. The link was then distributed to participants on social media (Facebook and WhatsApp). Following survey validation, a pilot study with 30 participants who met the inclusion criteria was carried out. The total scores for health literacy, adherence, and pandemic impact on hypertension control were calculated and compared across all independent variables. In a total of 144 study participants, controlled blood pressure was reported in 77% (N = 111). There were good levels of adherence and health literacy scores but moderate levels of pandemic impact scores. The total adherence scores showed a statistically significant difference between age groups (χ2 = 6.48, p = 0.039) and those who reported having controlled and uncontrolled blood pressure (U = 1116, p = 0.001). Moreover, the analysis revealed statistically significant differences in total pandemic impact scores based on the age group (χ2 = 15.008, p = 0.001), household income (χ2 = 6.887, p = 0.032), employment (U = 1712, p = 0.006), and marital status (U = 520.5, p < 0.001). The youngest age group (18–39) years, the lowest income group, unemployed and unmarried individuals, had significantly higher pandemic impact scores. This denotes that those individuals were more prone to be negatively affected by the pandemic regarding their hypertension management. Most participants reported relatively controlled blood pressure and good levels of health literacy as well as adherence amidst the pandemic. To a moderate extent, study participants perceived that the pandemic had a negative effect on hypertension management. The perceived negative impact of the pandemic was attributed to several socio-demographic factors, such as age, household income, employment, and marital status. Full article
14 pages, 398 KiB  
Article
Do Registered Dietitians, Nutrition Students, and Laypeople Perceive Individuals with Obesity Differently?
by Giovana Santarosa Cassiano, Joana Pereira Carvalho-Ferreira, Nicola J. Buckland and Diogo Thimoteo da Cunha
Int. J. Environ. Res. Public Health 2021, 18(17), 8925; https://doi.org/10.3390/ijerph18178925 - 25 Aug 2021
Cited by 4 | Viewed by 2283
Abstract
(1) Background: Obesity is associated with significant social consequences, and individuals with obesity are regularly affected by weight-related stigmatization experiences. This study compares antifat attitudes among registered dietitians (RD), nutrition students, and laypeople and assesses which factors related to the perceived causes of [...] Read more.
(1) Background: Obesity is associated with significant social consequences, and individuals with obesity are regularly affected by weight-related stigmatization experiences. This study compares antifat attitudes among registered dietitians (RD), nutrition students, and laypeople and assesses which factors related to the perceived causes of obesity influence these attitudes. (2) Methods: An online survey was conducted in Brazil with RD (n = 336), nutrition students (n = 300), and laypeople (n = 403) with questionnaires assessing antifat attitudes and perceived causes of obesity. (3) Results: All groups presented low antifat attitudes. Minor differences in antifat attitudes were found among the three groups. Compared to RDs and nutrition students, laypeople presented higher Weight Control/Blame scores, but with a small effect size (η2 = 0.01). Weight bias was predicted by age, sex, and body mass index. External, social, and financial factors were not perceived to be very important in the development of obesity by RD and students. (4) Conclusions: Since slight differences were seen among RD and students compared to laypeople, and some perceptions of the causes of obesity indicate a stigmatized view. It is essential to place a greater focus on educating and updating these health professionals and students about weight stigma and its consequences for the mental and physical health of individuals. Full article
13 pages, 795 KiB  
Article
Influence of Tunneled Hemodialysis-Catheters on Inflammation and Mortality in Dialyzed Patients
by Rodolfo Crespo-Montero, Victoria E. Gómez-López, Fátima Guerrero-Pavón, Andrés Carmona-Muñoz, Manuel Romero-Saldaña, Antonio Ranchal-Sanchez and Pedro Aljama-García
Int. J. Environ. Res. Public Health 2021, 18(14), 7605; https://doi.org/10.3390/ijerph18147605 - 16 Jul 2021
Cited by 4 | Viewed by 2249
Abstract
Older age and comorbidities in hemodialysis patients determines the use of tunneled catheters as vascular access despite their reported clinical and mortality disadvantages. This prospective matched study analyzes the impact of permanent catheters on inflammation and mortality in hemodialysis patients; We studied 108 [...] Read more.
Older age and comorbidities in hemodialysis patients determines the use of tunneled catheters as vascular access despite their reported clinical and mortality disadvantages. This prospective matched study analyzes the impact of permanent catheters on inflammation and mortality in hemodialysis patients; We studied 108 patients, 54 with AV-fistula (AVF) and 54 with indwelling hemodialysis catheters (HDC) matched by sex, age, diabetes and time under renal-replacement therapy comparing dialysis efficacy, inflammation and micro-inflammation parameters as well as mortality. Cox-regression analysis was applied to determine predictors of mortality, HDC patients presented higher C-reactive-protein (CRP) blood levels and percentage of pro-inflammatory lymphocytes CD14+/CD16+ with worse dialysis-efficacy parameters. Thirty-six-months mortality appeared higher in the HDC group although statistical significance was not reached. Age with a Hazard Ratio (HR) = 1.06, hypoalbuminemia (HR = 0.43), hypophosphatemia (HR = 0.75) and the increase in CD14+/CD16+ monocyte count (HR = 1.02) were predictors of mortality; elder patients dialyzing through HDC show increased inflammation parameters as compared with nAVF bearing patients, although they do not present a significant increase in mortality when matched by covariates. Increasing age and percentage of pro-inflammatory monocytes as well as decreased phosphate and serum-albumin were predictors of mortality and indicate the main conclusions or interpretations. Full article
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14 pages, 497 KiB  
Article
Patient Activation, Depressive Symptoms, and Self-Rated Health: Care Management Intervention Effects among High-Need, Medically Complex Adults
by Cynthia F. Corbett, Kenn B. Daratha, Sterling McPherson, Crystal L. Smith, Michael S. Wiser, Brenda K. Vogrig, Sean M. Murphy, Roy Cantu and Dennis G. Dyck
Int. J. Environ. Res. Public Health 2021, 18(11), 5690; https://doi.org/10.3390/ijerph18115690 - 26 May 2021
Cited by 3 | Viewed by 2042
Abstract
The purpose of this randomized controlled trial (n = 268) at a Federally Qualified Health Center was to evaluate the outcomes of a care management intervention versus an attention control telephone intervention on changes in patient activation, depressive symptoms and self-rated health [...] Read more.
The purpose of this randomized controlled trial (n = 268) at a Federally Qualified Health Center was to evaluate the outcomes of a care management intervention versus an attention control telephone intervention on changes in patient activation, depressive symptoms and self-rated health among a population of high-need, medically complex adults. Both groups had similar, statistically significant improvements in patient activation and self-rated health. Both groups had significant reductions in depressive symptoms over time; however, the group who received the care management intervention had greater reductions in depressive symptoms. Participants in both study groups who had more depressive symptoms had lower activation at baseline and throughout the 12 month study. Findings suggest that patients in the high-need, medically complex population can realize improvements in patient activation, depressive symptoms, and health status perceptions even with a brief telephone intervention. The importance of treating depressive symptoms in patients with complex health conditions is highlighted. Full article
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12 pages, 2018 KiB  
Article
Effectiveness of a Multicomponent Group Psychological Intervention Program in Patients with Inflammatory Bowel Disease: A Randomized Trial
by Purificación Bernabeu, Carlos van-der Hofstadt, Jesús Rodríguez-Marín, Ana Gutierrez, Miguel Raúl Alonso, Pedro Zapater, Rodrigo Jover and Laura Sempere
Int. J. Environ. Res. Public Health 2021, 18(10), 5439; https://doi.org/10.3390/ijerph18105439 - 19 May 2021
Cited by 9 | Viewed by 2653
Abstract
(1) Background: Stress, anxiety, and depression have been identified as factors that influence the development of inflammatory bowel disease (IBD). The main aim of this study was to test the effectiveness of group multicomponent cognitive-behavioral therapy at reducing stress, anxiety, and depression, and [...] Read more.
(1) Background: Stress, anxiety, and depression have been identified as factors that influence the development of inflammatory bowel disease (IBD). The main aim of this study was to test the effectiveness of group multicomponent cognitive-behavioral therapy at reducing stress, anxiety, and depression, and improving quality of life and the clinical course of the disease. (2) Methods: A total of 120 patients were evaluated using the General Perceived Stress Scale, Scale of Stress Perceived by the Disease, the anxiety and depression scale, and quality of life questionnaire for patients with IBD. Disease activity was measured using the Mayo Index for ulcerative colitis and CDAI for Crohn’s disease, as well as the number of relapses self-reported by patients. Patients were randomized to receive group multicomponent cognitive-behavioral therapy or treatment as usual. (3) Results: The psychological intervention reduced stress (EAE: 45.7 ± 8.8 vs. 40.6 ± 8.4, p = 0.0001; PSS: 28.0 ± 7.3 vs. 25.1 ± 5.9, p = 0.001) and improved quality of life (164.2 ± 34.3 vs. 176.2 ± 28.0, p = 0.001). An improvement was found in the number of relapses self-reported by patients (0.2 relapses/patient vs. control 0.7 relapses/patient; p = 0.027). No differences were found in disease activity indexes. (4) Conclusions: Psychological therapy was associated with improved stress, quality of life and with a decrease in the number of relapses self-reported by patients. Clinical trial registration number: NCT02614014. Full article
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15 pages, 819 KiB  
Article
Mindfulness at Methodist—A Prospective Pilot Study of Mindfulness and Stress Resiliency Interventions in Patients at a Tertiary Care Medical Center
by Elaina Vivian, Hellen Oduor, Preeti Girisha and Parvez Mantry
Int. J. Environ. Res. Public Health 2021, 18(8), 4034; https://doi.org/10.3390/ijerph18084034 - 12 Apr 2021
Cited by 3 | Viewed by 1950
Abstract
Individuals with chronic medical conditions like cancer often experience heightened stress levels that can impact medical decision-making. The aim of this study was assess the impact of mindful stress-reduction interventions in cancer patients and support group participants (which included current and former cancer [...] Read more.
Individuals with chronic medical conditions like cancer often experience heightened stress levels that can impact medical decision-making. The aim of this study was assess the impact of mindful stress-reduction interventions in cancer patients and support group participants (which included current and former cancer patients and their caregivers). A pilot study was conducted in which participants were provided a mindful stress-reduction intervention to determine whether they reduced stress, anxiety, and communication issues. Participants were provided a one-hour mindful stress-reduction intervention by a licensed physical therapist. Surveys were given to participants immediately before and after, and again 7-days after the intervention. Perceived stress was ascertained by asking participants: “Which emotional/mental state do you most frequently find yourself in?” Anxiety and communication abilities were measured using Neuro-QoL™ Anxiety and Communication v.1 instruments. Fifty-nine participants with a mean age of 60.6 years completed the study. Of these, 30.5%, 6.8%, 23.7%, and 39% were diagnosed (or were a caregiver to someone diagnosed) with pancreas, liver, breast, or unknown cancers, respectively. The surveys showed that participants’ perceived stress scores (p < 0.001), anxiety levels (p = 0.0067), and pain scores (p < 0.0001) were reduced after the mindful stress-reduction intervention. Larger studies with control groups are needed to confirm the interventions’ benefits. Full article
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9 pages, 335 KiB  
Article
Physical Activity and Quality of Life in Hemodialysis Patients and Healthy Controls: A Cross-Sectional Study
by Tjaša Filipčič, Špela Bogataj, Jernej Pajek and Maja Pajek
Int. J. Environ. Res. Public Health 2021, 18(4), 1978; https://doi.org/10.3390/ijerph18041978 - 18 Feb 2021
Cited by 15 | Viewed by 2875
Abstract
Hemodialysis (HD) patients have lower functional abilities compared to healthy people, and this is associated with lower physical activity in everyday life. This may affect their quality of life, but research on this topic is limited. Therefore, the present study aimed to determine [...] Read more.
Hemodialysis (HD) patients have lower functional abilities compared to healthy people, and this is associated with lower physical activity in everyday life. This may affect their quality of life, but research on this topic is limited. Therefore, the present study aimed to determine the relationship between habitual physical activity and quality of life in HD patients and healthy controls. Ninety-three HD patients and 140 controls participated in the study. Quality of life was assessed using a 36-item medical outcomes study short-form health survey (SF-36). Human Activity Profile (HAP) was used to assess habitual physical activity. The adjusted activity score (AAS) from HAP, age, gender, fat tissue index (FTI), lean tissue index (LTI), and Davies comorbidity score were analyzed as possible predictors of the Physical Component Summary (PCS) of the SF-36. Three sequential linear models were used to model PCS. In Model 1, PCS was regressed by gender and age; in Model 2 the LTI, FTI, and Davies comorbidity scores were added. Model 3 also included AAS. After controlling for age and gender (ModelHD 1: p = 0.056), LTI, FTI, and Davies comorbidity score effects (ModelHD 2: p = 0.181), the AAS accounted for 32% of the variation in PCS of HD patients (ModelHD 3: p < 0.001). Consequently, the PCS of HD patients would increase by 0.431 points if the AAS increased by one point. However, in healthy controls, AAS had a lower impact than in the HD sample (B = 0.359 vs. 0.431), while the corresponding effects of age and gender (ModelH 1: p < 0.001), LTI, FTI, and Davies comorbidity score (ModelH 2: p < 0.001) were adjusted for. The proportion of variation in PCS attributed to AAS was 14.9% (ModelH 3: p < 0.001). The current study results showed that physical activity in everyday life as measured by the HAP questionnaire is associated to a higher degree with the quality of life of HD patients than in healthy subjects. Routine physical activity programs are therefore highly justified, and the nephrology community should play a leading role in this effort. Full article
17 pages, 2757 KiB  
Article
Impact of Adverse Drug Reactions in Patients with End Stage Renal Disease in Greece
by Marios Spanakis, Marianna Roubedaki, Ioannis Tzanakis, Michail Zografakis-Sfakianakis, Evridiki Patelarou and Athina Patelarou
Int. J. Environ. Res. Public Health 2020, 17(23), 9101; https://doi.org/10.3390/ijerph17239101 - 06 Dec 2020
Cited by 10 | Viewed by 3212
Abstract
Background: Patients with end-stage renal disease (ESRD) require specialized therapeutic interventions. The decreased renal function that modulates the physiology and presence of comorbidities is often associated with variations in the pharmacological response, thus increasing the risk of adverse drug events or reactions (ADE/ADRs) [...] Read more.
Background: Patients with end-stage renal disease (ESRD) require specialized therapeutic interventions. The decreased renal function that modulates the physiology and presence of comorbidities is often associated with variations in the pharmacological response, thus increasing the risk of adverse drug events or reactions (ADE/ADRs) from co-administered drugs. Methods: A cross-sectional study to record comorbidities, drug–drug interactions (DDIs), ADE/ADRs in patients with chronic kidney disease of stage five in Greece. The study enrolled 60 patients of mean age 64.8 ± 12.9 years, undergoing hemodialysis three times a week. Demographic and social factors, comorbidities, laboratory test data, medication regimens, DDIs and the reporting of ADE/ADRs were analyzed. Results: Cardiovascular diseases and diabetes were the main comorbidities. In total, 50 different DDIs of various clinical significance were identified. CNS, GI-track, and musculoskeletal-system-related ADE/ADRs were most often reported by patients. ADE/ADRs as clinical outcome from DDIs were associated in 64% of the total identified DDIs. There was a positive trend between number of medications, ADE/ADRs report and DDIs. Conclusions: The impact of ADE/ADRs in ESRD patients should be always considered. Guidelines as well as continuous training in the context of evidence-based clinical practice by healthcare personnel on therapy administration and prevention of adverse events are important. Full article
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14 pages, 2067 KiB  
Article
Poor Sleep Quality Decreases Concurrent Training Benefits in Markers of Metabolic Syndrome and Quality of Life of Morbidly Obese Patients
by Pedro Delgado-Floody, Pedro Ángel Latorre-Román, Daniel Jerez-Mayorga, Felipe Caamaño-Navarrete, Johnattan Cano-Montoya, José Alberto Laredo-Aguilera, Juan Manuel Carmona-Torres, Ana Isabel Cobo-Cuenca, Diana P. Pozuelo-Carrascosa and Cristian Álvarez
Int. J. Environ. Res. Public Health 2020, 17(18), 6804; https://doi.org/10.3390/ijerph17186804 - 18 Sep 2020
Cited by 6 | Viewed by 3439
Abstract
Background: Sleep quality (SQ) plays a role in multiple activities of daily living, but little is known about its role in concurrent training [CT, high-intensity interval (HIIT) plus resistance training (RT)] adaptations for metabolic syndrome (MetS) and health-related quality of life (HRQoL) markers. [...] Read more.
Background: Sleep quality (SQ) plays a role in multiple activities of daily living, but little is known about its role in concurrent training [CT, high-intensity interval (HIIT) plus resistance training (RT)] adaptations for metabolic syndrome (MetS) and health-related quality of life (HRQoL) markers. The aim of the present study was to determine the effects of a 20-week CT programme on MetS and HRQoL markers according to the SQ of morbidly obese patients. Methods: Twenty-nine morbidly obese patients were allocated to one of two groups: good sleep quality (GSQ, n = 15, 38.07 ± 12.26 years) and poor sleep quality (PSQ, n = 14, 40.79 ± 11.62 years). HRQoL, body mass index, waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP, respectively), and plasma outcomes were measured. Results: The GSQ group reported significant changes (pre- vs. post-intervention) in WC (114.0 ± 3.1 vs. 110.4 ± 3.4 cm, p = 0.012), SBP (137.0 ± 4.3 vs. 125.6 ± 1.8 mmHg, p = 0.006), and HRQoL general health (51.33 ± 21.08 vs. 64.33 ± 16.24, p = 0.020). By contrast, the PSQ group showed significant changes only in SQ (9.00 ± 2.42 vs. 5.36 ± 2.84, p = 0.004). Conclusions: Morbidly obese PSQ patients showed a lower response for improving MetS and HRQoL markers after a 20-week CT programme than GSQ peers. However, there was a greater effect size for decreasing WC and SBP in favour of the GSQ compared with the PSQ group, suggesting that there are limitations to CT benefits on these outcomes in the PSQ group. These results call for more complex future studies. Full article
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29 pages, 420 KiB  
Article
Symptoms of Posttraumatic Stress, Anxiety, Depression, Levels of Resilience and Burnout in Spanish Health Personnel during the COVID-19 Pandemic
by Lourdes Luceño-Moreno, Beatriz Talavera-Velasco, Yolanda García-Albuerne and Jesús Martín-García
Int. J. Environ. Res. Public Health 2020, 17(15), 5514; https://doi.org/10.3390/ijerph17155514 - 30 Jul 2020
Cited by 378 | Viewed by 26148
Abstract
The number of health workers infected with COVID-19 in Spain is one of the highest in the world. The aim of this study is to analyse posttraumatic stress, anxiety and depression during the COVID-19 pandemic. Associations between burnout, resilience, demographic, work and COVID-19 [...] Read more.
The number of health workers infected with COVID-19 in Spain is one of the highest in the world. The aim of this study is to analyse posttraumatic stress, anxiety and depression during the COVID-19 pandemic. Associations between burnout, resilience, demographic, work and COVID-19 variables are analysed. Cross-sectional data on 1422 health workers were analysed. A total of 56.6% of health workers present symptoms of posttraumatic stress disorder, 58.6% anxiety disorder, 46% depressive disorder and 41.1% feel emotionally drained. The profile of a health worker with greater posttraumatic stress symptoms would be a person who works in the Autonomous Community of Madrid, in a hospital, is a woman, is concerned that a person he/she lives with may be infected, and thinks that he/she is very likely to be infected. The risk variables for anxiety and depression would be a person that is a woman, working 12- or 24-h shifts, and being worried that a family member could be infected. High scores on emotional exhaustion and depersonalization are risk factors for mental health, with resilience and personal fulfilment being protective variables. Data are provided to improve preventive measures for occupational health workers. Full article
14 pages, 619 KiB  
Article
Positive and Negative Changes in Food Habits, Physical Activity Patterns, and Weight Status during COVID-19 Confinement: Associated Factors in the Chilean Population
by Daniela Reyes-Olavarría, Pedro Ángel Latorre-Román, Iris Paola Guzmán-Guzmán, Daniel Jerez-Mayorga, Felipe Caamaño-Navarrete and Pedro Delgado-Floody
Int. J. Environ. Res. Public Health 2020, 17(15), 5431; https://doi.org/10.3390/ijerph17155431 - 28 Jul 2020
Cited by 149 | Viewed by 16246
Abstract
The association between the changes in lifestyle during coronavirus disease 2019 (COVID-19) confinement and body weight have not been studied deeply. Therefore, the aim of the present study was to determine lifestyle changes, such as eating habits and physical activity (PA) patterns, caused [...] Read more.
The association between the changes in lifestyle during coronavirus disease 2019 (COVID-19) confinement and body weight have not been studied deeply. Therefore, the aim of the present study was to determine lifestyle changes, such as eating habits and physical activity (PA) patterns, caused by confinement during the COVID-19 pandemic and to analyze its association with changes in body weight. Seven hundred participants (women, n = 528 and men, n = 172) aged between 18–62 years old of the Chilean national territory participated in the study. Food habits, PA, body weight, and sociodemographic variables were measured through a survey in May and June 2020. The body weight increase presented positive association with the consumption of fried foods ≥ 3 times per week (OR; 3.36, p < 0.001), low water consumption (OR; 1.58, p = 0.03), and sedentary time ≥6 h/day (OR; 1.85, p = 0.01). Conversely, fish consumed (OR; 0.67, p = 0.03), active breaks (OR; 0.72, p = 0.04), and PA ≥ 4 times per week (OR; 0.51, p = 0.001) presented an inverse association with body weight increase. Daily alcohol consumption (OR; 4.77, p = 0.003) was associated with PA decrease. Food habits, PA, and active breaks may be protective factors for weight increase during COVID-19 confinement. Full article
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10 pages, 371 KiB  
Article
Sexual Function in Levothyroxine-Treated Hypothyroid Women and Women without Hypothyroidism: A Case-Control
by Benjamín Romero-Gómez, Paula Guerrero-Alonso, Juan Manuel Carmona-Torres, José Alberto Laredo-Aguilera, Diana Patricia Pozuelo-Carrascosa and Ana Isabel Cobo-Cuenca
Int. J. Environ. Res. Public Health 2020, 17(12), 4325; https://doi.org/10.3390/ijerph17124325 - 17 Jun 2020
Cited by 6 | Viewed by 5138
Abstract
Background: Levothyroxine is the most common treatment to normalize thyroid hormones levels and to reduce primary hypothyroidism symptoms. Aim: To assess sexual function in women with levothyroxine-treated hypothyroidism and women without hypothyroidism. Methods: A case-control study was performed with 152 women with levothyroxine-treated [...] Read more.
Background: Levothyroxine is the most common treatment to normalize thyroid hormones levels and to reduce primary hypothyroidism symptoms. Aim: To assess sexual function in women with levothyroxine-treated hypothyroidism and women without hypothyroidism. Methods: A case-control study was performed with 152 women with levothyroxine-treated hypothyroidism and 238 women without hypothyroidism. An online survey was used to collect socio-demographic data and the answers to the Women Sexual Function (WSF) questionnaire. Results: Women with levothyroxine-treated hypothyroidism showed a higher prevalence of sexual dysfunction than women in the control group (31.60% vs. 16.40%), furthermore the presence of hypothyroidism increased the risk of sexual dysfunction (p = 0.002, OR: 2.29 (1.36−3.88)). The most affected domains were ‘desire’ (p < 0.001), ‘arousal’ (p = 0.003) and ‘penetration pain’ (p = 0.020). In hypothyroid women, age increased the risk of sexual dysfunctions (p = 0.009, OR: 1.07 (1.01−1.12)), however when age was adjusted (ANCOVA) the sexual dysfunction remained in women with hypothyroidism in all domains. Conclusions: Hypothyroidism is associated with an increase in the prevalence of sexual dysfunction even if treated with levothyroxine and thyroid-stimulating hormone (TSH) levels are normalized. Relevance to clinical practice: Sexual function in hypothyroid women should be assessed before and after starting the treatment. Full article

Review

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13 pages, 746 KiB  
Review
Flash Glucose Monitoring and Patient Satisfaction: A Meta-Review of Systematic Reviews
by Ana Díez-Fernández, María Dolores Rodríguez-Huerta, Rubén Mirón-González, José Alberto Laredo-Aguilera and Noelia María Martín-Espinosa
Int. J. Environ. Res. Public Health 2021, 18(6), 3123; https://doi.org/10.3390/ijerph18063123 - 18 Mar 2021
Cited by 11 | Viewed by 3310
Abstract
Flash glucose monitoring (FGM) systems have been suggested to have clinical beneficial effects in patients with diabetes mellitus, although their improvements in terms of quality of life (QoL) and patients’ satisfaction are not always addressed or are considered a secondary outcome. Thus, the [...] Read more.
Flash glucose monitoring (FGM) systems have been suggested to have clinical beneficial effects in patients with diabetes mellitus, although their improvements in terms of quality of life (QoL) and patients’ satisfaction are not always addressed or are considered a secondary outcome. Thus, the aim of this meta-review is to establish the benefits of FGM in terms of patients’ satisfaction and QoL in both type 1 and type 2 diabetes patients using evidence from past systematic reviews and meta-analyses. Major databases were searched for systematic reviews (with or without meta-analyses) that assessed the satisfaction or QoL of type 1 or 2 diabetes patients using FGM compared with other glucose monitoring systems. The quality of the included systematic reviews was addressed with the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool. Six systematic reviews (including two meta-analyses) were included in the meta-review. Evidence suggests that FGM systems seem to improve patients’ satisfaction and QoL compared with self-monitoring of blood glucose, although the high variability in the measurement tools, the clinical significance and the quality of the systematic reviews included do not allow us to state FGM benefits with any certainty. Further research, including high-quality randomised clinical trials, differentiating the needs of both type 1 and type 2 diabetes patients and focusing on psychosocial benefits for these patients is needed to optimise clinical decisions between patients and professionals by developing the right health technology assessment for FGM systems. Full article
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15 pages, 728 KiB  
Review
Eficacy of Cryotherapy in the Prevention of Oral Mucosistis in Adult Patients with Chemotherapy
by Ángel López-González, Marta García-Quintanilla, Carmen María Guerrero-Agenjo, Jaime López Tendero, Isabel María Guisado-Requena and Joseba Rabanales-Sotos
Int. J. Environ. Res. Public Health 2021, 18(3), 994; https://doi.org/10.3390/ijerph18030994 - 23 Jan 2021
Cited by 5 | Viewed by 3718
Abstract
Oral mucositis (OM) is a common side effect of cancer therapies. It causes ulcerative, painful lesions in the oral cavity that can provoke malnutrition, increased risk of infection, longer hospital stays, and seriously affect the quality of life. Cooling the mucosa with oral [...] Read more.
Oral mucositis (OM) is a common side effect of cancer therapies. It causes ulcerative, painful lesions in the oral cavity that can provoke malnutrition, increased risk of infection, longer hospital stays, and seriously affect the quality of life. Cooling the mucosa with oral cryotherapy (OC) during and/or after chemotherapy is the most accessible and tolerable intervention available. The aim of this study is to define the efficacy of OC for preventing OM induced by chemotherapy/radiotherapy in adult patients with cancer. Secondary endpoints include associated problems as pain. A systematic search was performed using the Pubmed, WOS (Web of Science), Cochrane Library, CINAHL, and BVS databases for articles published up to 2010. After inclusion and exclusion criteria were applied, a total of eight articles were analyzed in this review. In seven of the eight articles, the incidence of OM of all grades was significantly lower in the OC group compared with the no-OC group. Use of opioids and level of pain were also significantly reduced. OC is an effective intervention to reduce the incidence of OM induced by chemotherapy as well as the associated severity and pain. Based on these results, OC with only water or with chamomile, associated or not with other mouthwash therapies, is an effective intervention to reduce the incidence of OM induced by chemotherapy as well as the associated severity and pain. Full article
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